A 16-year-old girl presents with severe abdominal pain following a hug. The pain is sharp, constant, intense in the right upper quadrant, and radiates to her right shoulder. What's the diagnosis?
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions.
The patient also reports having mild, dull abdominal discomfort and a feeling of progressive abdominal fullness for the past few months but has not sought medical attention for these symptoms. She also complains of having a diffuse, itchy rash that seems to have appeared around the same time as the onset of the abdominal discomfort.
The patient has no history of food allergy and has not eaten any new foods before this episode. She does not report any fevers, nausea, or abnormal bowel movements. She has not had any changes in her skin coloration. She reports occasional use of acetaminophen in the past 2 weeks for the abdominal discomfort but is not otherwise taking any regular medications. She has no chronic medical conditions or past surgical history. She reports no significant family history.
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